A ESBL and carbapenemase-producing Enterobacteriaceae in infectious pleural effusions: current epidemiology at Hôpital du Mali

Aimé Césaire Kalambry; Tchamou Malraux Fleury Potindji; Ibrehima Guindo; Ambara Kassogué; Boubacar Sidiki Ibrahim Drame; Seydou Togo; Sadio Yena; Seydou Doumbia; Mahamadou Diakite

doi:10.33393/dti.2023.2613

Authors

Aimé Césaire Kalambry Medical Biology Laboratory, “Hôpital du Mali” Teaching Hospital, Bamako - Mali https://orcid.org/0000-0003-4325-1929
Tchamou Malraux Fleury Potindji Graduate School of Biological and Food Techniques, University of Lomé, Lomé - Togo https://orcid.org/0000-0001-5610-5432
Ibrehima Guindo National Institute of Public Health, Bamako - Mali https://orcid.org/0000-0003-3130-4763
Ambara Kassogué Medical Biology Laboratory, “Hôpital du Mali” Teaching Hospital, Bamako - Mali https://orcid.org/0009-0001-6058-5982
Boubacar Sidiki Ibrahim Drame Medical Biology Laboratory, “Hôpital du Mali” Teaching Hospital, Bamako - Mali
Seydou Togo Department of Thoracic Surgery, “Hôpital du Mali” Teaching Hospital, Bamako - Mali
Sadio Yena Department of Thoracic Surgery, “Hôpital du Mali” Teaching Hospital, Bamako - Mali
Seydou Doumbia Faculty of Medicine and Odontostomatology of Bamako, Bamako - Mali and University Clinical Research Center (UCRC), University of Science, Technique and Technologies of Bamako, Bamako - Mali
Mahamadou Diakite University Clinical Research Center (UCRC), University of Science, Technique and Technologies of Bamako, Bamako - Mali and Malaria Research and Training Center (MRTC), Bamako - Mali https://orcid.org/0000-0002-4268-8857

DOI:

https://doi.org/10.33393/dti.2023.2613

Keywords:

Carbapenem-resistant Enterobacteriaceae, ESBL, Mali, Pleural effusions

Abstract

Background: Antimicrobial resistance (AMR) is a global health concern, with extended-spectrum β-lactamases (ESBLs) and carbapenemases being major contributors. Pleural infection (PI) is a severe condition in West Africa, complicated by AMR. This study aimed to investigate the prevalence and molecular characteristics of ESBL and carbapenemase-producing enterobacteria in pleural effusions in Mali.

Materials and methods: Pleural fluid samples from 526 patients with pleuritis were analyzed. Enterobacterial species were isolated and identified, and the prevalence of resistance genes (bla_OXA-48, bla_NDM-1, bla_KPC, bla_TEM, bla_SHV) and virulence factors was determined.

Results: Among the patients, 110 were diagnosed with enterobacterial pleuritis. Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis were the main pathogens identified. Resistance to β-lactams and cephalosporins was high, while carbapenems showed good activity. ESBL production was detected in 33.6% of isolates, with bla_TEM being the most common gene. Carbapenemase gene (bla_NDM-1) was found in three isolates.

Conclusion: The study highlights the high prevalence of multidrug-resistant bacteria and the need for appropriate antibiotic selection based on local resistance patterns. Understanding the molecular characteristics of resistance is crucial for optimizing patient care and developing effective therapeutic strategies. Further research is needed to monitor and control AMR in PIs in Mali.

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